Key Tips on Hydration Volume 1: Hydration Needs for different life stages http://www.europeanhydrationinstitute.org/

1.
Key Tips on Hydration (Volume 1)
Hydration needs for different life stages
Index
• Key Tips on Hydration for infants and children.
• Key Tips on Hydration for adolescents and adults.
• Key Tips on Hydration for elderly people.
• Key Tips on Hydration for pregnant and breastfeeding women.

2. for infants and children
KEY TIPS
ON HYDRATION
The hydration needs of children are not that
different to those of adults. However, infants and
children are more susceptible to dehydration
than adults. According to the Panel on Dietetic
Products, Nutrition and Allergies from the
European Food Safety Authority (EFSA)1
2010,
the values for total water intake shown in the
adjacent table are those recommended for infants
and children under conditions of moderate
environmental temperature and moderate
physical activity levels.
Age range Daily adequate water intake1
Infants
0-6 months
680 mL/day or 100-190 mL/
kg/day. From human milk/
infant formula.
6-12 months
0.8-1.0 L/day. From human
milk/infant formula and
complementary foods and
beverages.
1-2 years 1.1-1.2 L/day
Children
2-3 years 1.3 L/day
4-8 years 1.6 L/day
• Compared to children and adults, infants have a higher total body water content. In newborns the
total body water content can be as much as 75% and this decreases to 50-60% by the time they
reach adulthood.
• Infants and children need water not only to replace the losses via respiration, sweating and urine,
but also for growth.
• Instances of diarrhoea and vomiting are frequent in infants and young children and both can lead
to dehydration if water losses are not replaced .
• Infants cannot easily communicate their needs and active children can be so involved in what they
are doing that they forget to drink, so it is important for those caring for them to be alert to the
possibility of dehydration especially during hot weather or during periods of illness.
It is important to remember that:
The Panel on Dietetic Products, Nutrition and Allergies from the European Food Safety Authority (EFSA)* issued reference
intakes for water in 2010. These are defined as total water intake, which is water from beverages (including drinking water)
and from food moisture. It is normally assumed that the contribution of food to total dietary water intake is 20 to 30%, while 70
to 80% is provided by beverages. This relationship is not fixed and depends on the type of beverage and on the choice of foods.
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3. KEY TIPS ON HYDRATION
How to ensure proper hydration
of infants and children
Infants
During breastfeeding healthy infants can maintain adequate hydration status while exclusively
breastfed without additional water, even in very hot weather.
Additional water intake may be needed from 0 to 6 months when an infant formula is used, or from
6 to 12 months when formula or other weaning food with higher energy and nutrient density is used.
Children
These are practical tips to keep active children hydrated, especially in hot environments:
• Have children drink before heading out to play and call them in frequently for drinks.
• To avoid overheating, encourage regular breaks in the shade when the sun is hot.
• Keep drinks cool whenever possible and offer beverages that your child enjoys. All beverages,
including water, milk, juice, soft-drinks, and other fluids, can help meet a child’s hydration needs..
• Remember that many foods have a high water content and contribute to total fluid intake. Fruits,
vegetables, and some other foods are high in water content.
There is some evidence that providing drinks to children can help them to perform better in
standardised tests of concentration, short term memory and other essential elements of the learning
process. Hydration needs should therefore also be considered when children are at school.
70-80%from beverages (all types, not just
plain water)1,2
20-30%typically comes from food and
It is calculated that of
the total water consumed…
However, this may vary greatly
depending of the diet that an individual
chooses.1,2
To know more about the sources of water, please visit us at:
http://www.europeanhydrationinstitute.org/nutrition_and_beverages.html
1. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary reference values for water. EFSA Journal 2010; 8(3):1459.
Available online: http://www.efsa.europa.eu/en/efsajournal/pub/1459.htm
2. Manz F, Johner SA, Wentz A, Boeing H, Remer T. Water balance throughout the adult lifespan in a German population. Br J Nutr 2011; 1-9 [Epub ahead
of print]

4. for adolescents and adults
KEY TIPS
ON HYDRATION
The body requires water to survive and function
properly. Humans cannot live without drinking
for more than a few days – depending on weather,
activity levels and other factors- whereas other
nutrients may be neglected for weeks or months.
Although commonly it is treated rather trivially,
no other nutrient is more essential or is needed
in such large amounts.
Water requirements vary between individuals
and according to diet, environmental conditions,
activity levels and a range of other factors. As a
reference, the adjacent table shows the values for
total water intake for each age group, as issued
by the Panel on Dietetic Products, Nutrition
and Allergies from the European Food Safety
Authority (EFSA)1
on 2010.
Age range
Daily adequate
water intake1
Adolescents (Males / Females)
9-13 years 2.1 L/day / 1.9 L/day
14-18 years 2.5 L/day / 2.0 L/day
Adults (Males / Females)*
›19 years 2.5 L/day/ 2.0 L/day
* Some groups are at a higher risk of dehydration (elderly people) or are special cases that need higher quantities of water (pregnant and lactating
women). Please read our special advice for these groups at: http://www.europeanhydrationinstitute.org/elderly_people.html and
http://www.europeanhydrationinstitute.org/pregnancy_a_lactation.html
That the amount of water that is deemed
adequate includes not only water from
drinking water, but also beverages of all
kinds and from food moisture.
That the reference values included in this
recommendation only apply to conditions of
moderate environmental temperature and
moderate physical activity levels.
That thirst appears in the middle-stage
of dehydration so it’s better to drink on a
regular basis.
To know more about the water requirements of
your body, please visit us at:
http://www.europeanhydrationinstitute.org/
hydration_needs.html
It is important to take into
account...
Are you aware of how much
water you need?
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5. KEY TIPS ON HYDRATION
Type of beverage / food Water content
Non-alcoholic beverages*
Water, tea, coffee, light refreshments, sports drinks, soft drinks, lemonade, vegetable juice 90% to 100%
Milk, fruit juice, juice beverages 85% to 90%
Soups
Including consommé and creams made with milk, etc. 80% to 95%
Fruits and vegetables
Strawberry, melon, grapefruit, grape, peach, pear, orange, apple, cucumber, lettuce, celery, tomato,
pumpkin, broccoli, onion, carrot
80% to 95%
Banana, potato, corn 70% to 80%
Dairy products
Fresh whole milk 87 to 90%
Yoghurt 75% to 85%
Ice creams 60% to 65%
Cheese 40% to 60%
Cereals
Rice (boiled) 65% to 70%
Pasta (spaghetti, macaroni, noodles) 75% to 85%**
Bread, cookies 30% to 40%
Breakfast cereals (ready to eat) 2% to 5%
Meat, Fish, Eggs
Fish and seafood 65% to 80%
Eggs (scrambled, fried, poached), omelette, egg substitute 65% to 75%
Beef, chicken, lamb, pig, veal 40% to 65%
Cured meat, bacon 15% to 40%
Adapted from: Holland B. et al (1991) McCance and Widdowson. The Composition of Foods 5th ed. The Royal Society of Chemistry Cambridge, UK.
* Softer alcoholic beverages such as beer may have an important cultural weight in some countries. Beer and wine contain 85% to 95% of water
whereas distilled alcoholic drinks typically contain only 57% - 70% water.
**Note that these values are approximations only and values will depend on source of the food, cooking method, etc. For example pasta cooked “al
dente” (Italian style) will have a slightly lower water content than shown here** and is between 50 and 60%. There are many good online databases
that will give food composition values for a much wider range of foods.
1. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary reference values for water. EFSA Journal 2010;
8(3):1459. Available online: “http://www.efsa.europa.eu/en/efsajournal/pub/1459.htm”www.efsa.europa.eu/en/efsajournal/pub/1459.htm
2. Manz F, Johner SA, Wentz A, Boeing H, Remer T. Water balance throughout the adult lifespan in a German population. Br J Nutr 2011; 1-9 [Epub
ahead of print]
Where can I get the water from?
70-80%from beverages (all types, not just
plain water)1,2
The following are the average water contents of different kinds of non-alcoholic beverages and foods,
which may give you an idea of the water intake you get according to your own food choices.
20-30%typically comes from food and
It is calculated that of
the total water consumed…
However, this may vary greatly
depending of the diet that an individual
chooses.1,2

6. for ELDERLY PEOPLE
KEY TIPS
ON HYDRATION
• People usually drink in response to thirst, but by the age of 60, if people only drink when they
are thirsty, they may not get as much water as they need.
• Renal concentrating capacity generally declines with the age, leading to an increased loss of
water via urine.
• Diminished appetite and poor food choices may lead to a reduction of fluid intake from food.
• Some older adults may suffer from poor memory, immobility, or illness which may affect fluid
intake. In addition, certain medications can also block the thirst mechanism.
• Dehydration can cause serious problems in older adults. Elderly people are at greatest risk
of dehydration and its potentially life-threatening consequences: People aged between 85-99
years are 6 times more likely to be hospitalised for dehydration than those aged 65-69 years.
• Chronic dehydration constitutes a serious problem and is associated with an increased risk
of falls, urinary tract infections, dental disease, bronchopulmonary disorders, kidney stones,
constipation, and impaired cognitive function.
Special considerations for the elderly
Are you aware of their
increased risk oF dehydration?
2 L for women
2.5 L for men
under conditions of moderate environmental
temperature and moderate physical activity levels.
But age-related changes can lead to an increased risk of
dehydration with consequent effects on health and wellness.
The EFSA adult recommendations for the daily
intake of water from all sources*
(water, beverages and food) do not fall with age
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7. KEY TIPS ON HYDRATION
How to ensure proper
hydration IN THE ELDERLY
These are practical tips to help keep elderly people well hydrated
• A hydration programme should include advice on drinking, offering fluids at mealtime and in
between meals. Fluids should be readily available and physically accessible both day and night.
• Carers should be familiar with dietary changes so that appropriate hydration recommendations
can be made.
•Environmentaltemperaturesinsideshouldbemoderate.Inhotenvironments,itisrecommended
that intake of liquids be increased by 250 mL for each degree centigrade over 37ºC.
• Strong (distilled) alcoholic beverages may provoke dehydration and are not recommended.
• Many types of foods contain a substantial amount of water. If an older person finds it difficult
to increase the amount of fluid drunk, increasing the intake of foods, such as soups or fruit
and vegetables, which typically contain 80-90 per cent water, can help to maintain an adequate
water intake as well as being good sources of essential nutrients.
• Varying flavours and even colours can improve palatability of beverages offered and can help
facilitate adequate hydration.
To know more about the sources of water, please visit us at:
http://www.europeanhydrationinstitute.org/nutrition_and_beverages.html
* Source: EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary reference values for water. EFSA Journal 2010;
8(3):1459. Available online: http://www.efsa.europa.eu/en/efsajournal/pub/1459.htm
The Panel on Dietetic Products, Nutrition and Allergies from the European Food Safety Authority (EFSA)* issued reference
intakes for water in 2010. These are defined as total water intake, which is water from beverages (including drinking
water) and from food moisture. It is normally assumed that the contribution of food to total dietary water intake is 20 to
30%, while 70 to 80% is provided by beverages. This relationship is not fixed and depends on the type of beverage and on
the choice of foods.

8. for PrEgnant and
breastfeeding women
KEY TIPS
ON HYDRATION
• Pregnancy Increased water needs in
pregnancy arise because of the weight
gained (typically 10-15 kg), the higher energy
intake, the increase in blood volume, the
formation of amniotic fluid and because of
increased water output which can occur as a
result of morning sickness.
Meeting water needs through diet may
be more difficult in pregnant than in non
pregnant women because of food aversions
and/or avoidance of fluid intake when
morning sickness appears. It follows that
pregnant women may be more vulnerable to
dehydration.
• Breastfed babies take in an average of about
750 mL of milk per day (600-900 mL) between
the ages of 1 and 6 months. Breastfeeding
mothers therefore lose significant amounts
of fluid during nursing and need to increase
their fluid intake to compensate.
Mild dehydration does not affect milk
supply, but moderate to severe dehydration
may have an effect, including changing the
composition of the milk and decreasing the
amount of milk produced. Dehydration will
also add to feelings of tiredness at what can
be a very stressful time.
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Water needs increase during pregnancy
and breastfeeding:
WATER INTAKE RECOMMENDATION
The European Food Safety Authority (EFSA)1
has made the following recommendations for
adequate intakes of water for pregnant and breastfeeding women:
Status EFSA Recommendation
Daily adequate intake of
water from all sources
Pregnant
An additional water intake of 300 mL on top of
the 2 L per day adequate intake recommended
for non-pregnant women.
2.3 L
Breastfeeding
An additional 600 – 700 mL per day on top of
the 2 L per day adequate intake recommended
for non-breastfeeding women.
2.7 L

9. KEY TIPS ON HYDRATION
To know more about the sources of water, please visit us at:
http://www.europeanhydrationinstitute.org/nutrition_and_beverages.html
1. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary reference values for water. EFSA Journal 2010;
8(3):1459. Available online: http://www.efsa.europa.eu/en/efsajournal/pub/1459.htm
2. Manz F, Johner SA, Wentz A, Boeing H, Remer T. Water balance throughout the adult lifespan in a German population. Br J Nutr 2011; 1-9 [Epub
ahead of print]
What to drink?
Good choices include water (mineral or tap), fruit juices, herbal teas, soft drinks, and decaffeinated
tea and coffee.
70-80%
from beverages (all types,
not just plain water)1,2
20-30%typically comes from food and
It is calculated that of
the total water consumed…
However, this may vary greatly
depending of the diet that an
individual chooses.1,2
HOW TO ENSURE PROPER
HYDRATION WHILST PREGNANT
OR BREASTFEEDING
Drink plenty of fluids:
• During pregnancy hydration plays an essential role since an adequate supply of water is essential
for meeting the water needs of your body and of the baby (water represents 94% of the baby’s
weight at the end of the first trimester). Water is also needed for the renewal of amniotic fluid,
the baby’s living environment. Not drinking enough water can lead to constipation and then to
haemorrhoids which are a common complication during pregnancy.
• Proper hydration during breastfeeding ensures milk supply. It is always good practice to have a
beverage nearby whilst breastfeeding.
• When choosing food and beverages it is important to take into account that small amounts of food
or beverages can pass to the baby via the breast milk. Drinks containing caffeine can affect your
baby and may keep them awake. While your baby is young, drink caffeinated drinks occasionally
rather than every day. Caffeine occurs naturally in many foods and drinks, including coffee, tea
and chocolate. It’s also added to some soft drinks and energy drinks, and to some cold and flu
remedies.

10.
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